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CASE REPORT
Successful use of anakinra for colchicine-intolerant, corticosteroid-dependent recurrent pericarditis secondary to postcardiac injury syndrome after pacemaker placement
  1. Muhammad Hamza Saad Shaukat1,
  2. Muhammad Asim Shabbir1,
  3. Sulagna Mookherjee2 and
  4. Ruben Peredo-Wende3
  1. 1 Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
  2. 2 Cardiology, Albany Medical Center Hospital, Albany, New York, USA
  3. 3 Division of Rheumatology, Internal Medicine, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Muhammad Hamza Saad Shaukat, hamzasaad1991{at}gmail.com

Abstract

A 54-year-old woman was referred to our centre for the third recurrence of colchicine-intolerant, corticosteroid dependent iatrogenic post-traumatic pericarditis after pacemaker placement 3 months prior to the first episode. The initial episode and each recurrence were associated with a pericardial effusion requiring drainage. Evaluation for pericardial infection, malignancy, autoimmune disease and pacemaker lead perforation was negative. After fourth recurrence and fifth pericardial drainage in 3 months, a trial of anakinra (interleukin-1 inhibitor), in addition to swift symptom resolution successfully prevented subsequent symptomatic and echocardiographic recurrence. Corticosteroids were tapered and eventually discontinued. At 4-month follow-up, the patient continues to be on daily anakinra 100 mg subcutaneous (SQ) daily without adverse effects.

  • Pericardial Disease
  • Therapeutic Indications
  • Pacing And Electrophysiology
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Footnotes

  • Contributors MHSS: involved in reviewing literature and writing the manuscript. MAS: wrote and revised the manuscript. SM: involved in patient care, literature review and critical review of final manuscript. RP-W: conceived the structure and premise of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Qot commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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